[MOL] Part 3 of HMO SERIES..... [00699] Medicine On Line


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[MOL] Part 3 of HMO SERIES.....



As the fall elections approach, voters may be wondering: Whatever happened to health care, the perennial issue that is supposed to electrify the electorate but always seems to disappear by November?
      This year, the health care bills so hotly debated last summer — both those drafted by Democrats and those written by Republicans — failed to get far enough along in the legislative process to become law. Now, health care appears to have been set aside for congressional debate next year.
      The issues Republicans and Democrats couldn't agree on this year will likely be the same issues they'll debate next year — a tedious enough prospect for most voters. But those issues could change the way you and your family manage your health. And the candidate you vote for this fall could help decide which doctors you will be allowed to see, how you handle an insurance dispute and what it may cost you.
      To review, on March 31, 1998, Senate Minority Leader Tom Daschle, D-S.D., introduced the Patients' Bill of Rights, legislation that had strong support from President Clinton. The proposed legislation called for unlimited access to health care specialists. For example, women would be permitted to see a gynecologist or obstetrician without getting permission first from a primary care physician.
      The Patients' Bill of Rights also called for better access to emergency care, banned rules that keep physicians from discussing expensive treatment options, allowed patients to appeal to independent medical experts if they were denied coverage and gave patients the right to sue their health maintenance organizations. (Currently, people who receive health care coverage through an employer cannot sue their HMO for denying care that results in injury or death.)
      "We were disappointed Congress didn't pass it," says Joan Alker, spokeswoman for Families USA, an organization devoted to health care reform. "This problem isn't going to go away and it's only going to get worse. Working families are having to pay more and more of the premium."
      Last summer the GOP drafted its own version of health care reform. The Republican plan was similar to the Democrats', but it did not give consumers the right to sue. The GOP plan also provided a tax break for the self-employed. Currently, those who are self-employed person can deduct only 45 percent of their health insurance expenses. Under the Republican proposal, that person could deduct 100 percent of health insurance costs, a regulation that would have affected about 3 million people.
      Another major difference between the two proposals: the Democratic bill would have affected 150 million health care consumers. The Republican legislation was far more exclusive, applying to only the 48 million people currently covered by federally-regulated health insurance plans.
      Republicans said the Democratic bill would drive up health care costs and make affordable insurance more difficult to find. According to a report from the Congressional Budget Office, the Democrats' plan would have cost about $6.50 more a month for every insured American, a sentiment echoed by the Health Insurance Association of America in Washington, D.C.
      "Legislation or regulation, no matter how well-intended, raises the costs of coverage," says Richard Coorsh, spokesman for the Health Insurance Association of America in Washington, D.C. "We think these things should be implemented privately, not by government action."
      And, in fact, government action is not forthcoming — at least, not until next year. For consumers, the best advice may be to educate yourself as best as possible about your health care plan, and about managing your own care.

Warmly, lillian
 
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